Yes, you're right that there's a lot of debate about how/whether to treat low-grade, early-stage prostate cancer.

There are many of us with high-grade and/or advanced prostate cancer here in the forum, but I don't think we're representative; it's just that people with more-dangerous cancer are more likely to seek out information and discussion groups. My radiation oncologist told me that about 5% of prostate cancers (1 in 20) are like mine: fast moving, strike people young, and often aren't discovered until they've already metastasised.

Obviously, for people in my situation, there's no choice: treat it aggressively, or die in a few years (or less; Canada's former Leader of the Opposition, Jack Layton, was diagnosed with advanced PCa in 2010 around age 60 and died in 2011). For people with very low-grade PCa, the choice is either active surveillance or (to be on the safe side), a few months of ADT, which will have no permanent impact once it wears off.

The tough decisions lie in the middle: what if your Gleason score is high, but the cancer doesn't appear to have escaped the prostate? Do you make a life-altering change like removing or radiating the prostate? There's no *wrong* choice, just the choice that works for you.

While I wish we'd caught mine at that early stage, I still don't envy you the decisions you have to make.